Lacourt, David Joseph

Lacourt, David Joseph is an sole proprietor health care provider with primary practice located at 4004 Carlisle Blvd Ne Suite F, Albuquerque NM 87107-4565. He recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Psychologist, Behavioral Health & Social Service Providers / School. Behavioral Health & Social Service Providers / Psychologist is his primary health care specialty. Lacourt, David Joseph can be contacted via phone (505) 830-1629.

Contact Information

Primary practice address
4004 Carlisle Blvd Ne Suite F Albuquerque NM 87107-4565
Fax: (505) 869-1640
Website:

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Psychologist 103T00000X 525 New Mexico
Behavioral Health & Social Service Providers / Psychologist 103T00000X 6301002442 Minnesota
Behavioral Health & Social Service Providers / School 103TS0200X 240926 New Mexico

Profile Details

NPI number 1316097736
LBN Legal business name Lacourt, David Joseph
Credentials PH.D.
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jan 10th, 2007
Last updated Jul 8th, 2007 - about 18 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1316097736 NPPES
New Mexico MEDICAID N0981

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